Provider Demographics
NPI:1063289460
Name:HARDWICK, MADELYN TAYLOR
Entity type:Individual
Prefix:
First Name:MADELYN
Middle Name:TAYLOR
Last Name:HARDWICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10399 NORMAN RD
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-8551
Mailing Address - Country:US
Mailing Address - Phone:317-902-2373
Mailing Address - Fax:
Practice Address - Street 1:6845 E US HIGHWAY 36 STE 500
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-9781
Practice Address - Country:US
Practice Address - Phone:812-247-8010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34010831A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical